Introduction Febrile neutropenia is a serious complication associated with chemotherapy. Neutropenia may arise from bone marrow suppression, a common toxicity of chemotherapy, or the cancer itself, radiation, or another pathological process can triggered it. Neutropenic is a risk factor infection in patients with hemato-oncological diagnoses, and fever is a common symptom among neutropenic patients. Managing febrile neutropenia is an oncological emergency that requires immediate treatment due to it is a life-threatening nature.

Aim To reduce antibiotic administration time to less than 60 minutes in pediatric patients with hemato-oncological diagnoses and fever (PHODf), through the implementation of the ‘Hora Dorada’ collaborative in a high-level hospital in Mexico.

Methods The ‘Hora Dorada’ is a collaborative effort between the network ‘México en alianza con St. Jude’ and the Institute for Healthcare Improvement (IHI). This project employs continuous improvement methodology and the IHI’s ‘Breakthrough Series’ model. Initiated at our high-level hospital in 2022, we are currently in the implementation phase. We have used change ideas such as the ‘doradito’, continuous training, dissemination of results and recognition of ‘personal dorado’.

Results Before implementation, we had five patients; while post-implementation, we have treated eighty-four patients. There is a significant difference in the time from triage to antibiotic administration (115 minutes vs. 55.5, p=0.041), in the incidence of sepsis (40% vs. 2.4%, p=0.015), and intensive care unit admission (ICU) (40% vs. 1.2%, p=0.007).

Conclusions The ‘Hora Dorada’ implementation has positive impact in the outcomes of PHODf, particularly in terms of reducing the incidence of sepsis and ICU admissions. Further efforts are necessary to ensure the sustainability of these improvements.